Background
Inspired by her time as a medical student early in the COVID pandemic, Dr. Kristine Cueva is interested in the underpinnings of health inequalities at the end of life, particularly relating to communication.
There is evidence that Black patients nearing the end of life have greater symptom burden, worse quality of life, and receive more intense clinical care.
The methods historically used to elucidate drivers apply the assumption that mistrust is an inherent personal quality rather than result of lived experiences.
Methods
Aiming to address this methods gap, Dr. Cueva designed and led a mixed methods study to better understand patient perspectives. With collaborators, she enrolled a prospective cohort of Black patients with a 2-year or less predicted life expectancy.
The investigators administered the Group Based Medical Mistrust survey and performed semi-structured interviews.
Results
The average numeric survey-based measures of mistrust were higher in this study sample than other published populations. Subjects shared perspectives that doctors/healthcare workers sometimes dismiss medical complaints, hide information from, and treat differently members of the subject’s ethnic group.
“This research highlights that critical, race-conscious research methods are needed to better understand racial health inequities. This research can inform new strategies and frameworks to improve the trustworthiness of healthcare workers and institutions.”
Dr. Cueva presented this research at the American Thoracic Society International Conference in May 2023 and is preparing the manuscript.
She aspires to a career in Pulmonary & Critical Care Medicine. In partnership with her mentor, Dr. Crystal Brown, she plans to continue research in the area of communication with marginalized groups at the end-of-life as progress toward implementing positive changes in the healthcare environment that better serve marginalized groups.
Dr. Cueva acknowledges her mentor, Dr. Crystal Brown, and collaborators: Arisa Marshall, Dr. Cyndy Snyder and Dr. Bessie Young.